No office rate
Choose 38747 for regional abdominal nodal removal. 38780 describes a more extensive transabdominal retroperitoneal dissection that includes pelvic, para-aortic, and iliac nodes.
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CMS RVU26D · Effective 2026-10-01
38747 Abdominal lymphadenectomy Medicare reimbursement rates
Reports regional removal of abdominal lymph nodes, such as celiac, superior mesenteric, and para-aortic nodes, as an add-on to a primary operation. Compare 38747 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 38747?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 38747 pays more and less
Lymphatic surgery
About 38747: Regional abdominal lymph node dissection
Reports regional removal of abdominal lymph nodes, such as celiac, superior mesenteric, and para-aortic nodes, as an add-on to a primary operation.
This add-on describes regional lymph node removal in the abdomen, including nodes in the celiac, superior mesenteric, and para-aortic areas. A surgeon may perform it during an operation for an abdominal malignancy when nodal tissue is removed for treatment or staging. General surgeons and surgical oncologists commonly perform these dissections; other surgical specialists may do so when treating cancers within their fields.
Report 38747 only with a primary procedure. The operative report should identify the abdominal nodal basin removed and describe the dissection sufficiently to distinguish regional node removal from a more extensive retroperitoneal dissection. CMS pays the add-on within the primary procedure’s global period, so related postoperative care is governed by that primary procedure’s global period. A pelvic-only dissection or a dissection involving broader retroperitoneal and pelvic basins may point to a different code.
CMS billing rules for 38747
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU4.76 · 66%
- Practice expense (office) RVU1.22 · 17%
- Malpractice RVU1.19 · 17%
1.3K
Medicare services in 2024 · #2781 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
38747 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
38770 is for pelvic lymphadenectomy, including specified pelvic nodal groups; 38747 is for regional abdominal nodes such as celiac and superior mesenteric nodes.
No office rate
38746 describes regional thoracic lymphadenectomy. Use 38747 when the nodal dissection is in the abdomen.
See how rates vary across the country
38747 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 38747 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $217.14 |
| Alaska* | Office Unavailable | Facility $303.78 |
| Arizona | Office Unavailable | Facility $232.50 |
| Arkansas | Office Unavailable | Facility $214.46 |
| Atlanta | Office Unavailable | Facility $248.60 |
| Austin | Office Unavailable | Facility $237.63 |
| Bakersfield | Office Unavailable | Facility $230.88 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $254.42 |
| Beaumont | Office Unavailable | Facility $232.99 |
| Brazoria | Office Unavailable | Facility $231.65 |
| Chicago | Office Unavailable | Facility $292.27 |
| Chico | Office Unavailable | Facility $227.66 |
| Colorado | Office Unavailable | Facility $235.30 |
| Connecticut | Office Unavailable | Facility $254.15 |
| Dallas | Office Unavailable | Facility $235.11 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $259.81 |
| Delaware | Office Unavailable | Facility $235.78 |
| Detroit | Office Unavailable | Facility $265.32 |
| East St. Louis | Office Unavailable | Facility $276.53 |
| El Centro | Office Unavailable | Facility $227.86 |
| Fort Lauderdale | Office Unavailable | Facility $272.13 |
| Fort Worth | Office Unavailable | Facility $235.22 |
| Fresno | Office Unavailable | Facility $227.66 |
| Galveston | Office Unavailable | Facility $233.63 |
| Hanford-Corcoran | Office Unavailable | Facility $227.66 |
| Hawaii, Guam | Office Unavailable | Facility $228.33 |
| Houston | Office Unavailable | Facility $255.42 |
| Idaho | Office Unavailable | Facility $215.28 |
| Indiana | Office Unavailable | Facility $216.08 |
| Iowa | Office Unavailable | Facility $212.05 |
| Kansas | Office Unavailable | Facility $215.86 |
| Kentucky | Office Unavailable | Facility $231.58 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $240.11 |
| Madera | Office Unavailable | Facility $227.66 |
| Manhattan | Office Unavailable | Facility $279.55 |
| Merced | Office Unavailable | Facility $227.66 |
| Metropolitan Boston | Office Unavailable | Facility $249.54 |
| Metropolitan Kansas City | Office Unavailable | Facility $236.08 |
| Metropolitan Philadelphia | Office Unavailable | Facility $251.69 |
| Metropolitan St. Louis | Office Unavailable | Facility $237.61 |
| Miami | Office Unavailable | Facility $301.93 |
| Minnesota | Office Unavailable | Facility $212.68 |
| Mississippi | Office Unavailable | Facility $223.45 |
| Modesto | Office Unavailable | Facility $227.66 |
| Montana** | Office Unavailable | Facility $239.40 |
| Napa | Office Unavailable | Facility $242.90 |
| Nebraska | Office Unavailable | Facility $211.62 |
| Nevada** | Office Unavailable | Facility $232.89 |
| New Hampshire | Office Unavailable | Facility $236.19 |
| New Mexico | Office Unavailable | Facility $244.09 |
| New Orleans | Office Unavailable | Facility $242.49 |
| North Carolina | Office Unavailable | Facility $222.41 |
| North Dakota** | Office Unavailable | Facility $215.87 |
| Northern Nj | Office Unavailable | Facility $258.72 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $291.42 |
| Ohio | Office Unavailable | Facility $236.26 |
| Oklahoma | Office Unavailable | Facility $226.26 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $236.37 |
| Portland | Office Unavailable | Facility $236.38 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $258.86 |
| Puerto Rico | Office Unavailable | Facility $239.34 |
| Queens | Office Unavailable | Facility $274.64 |
| Redding | Office Unavailable | Facility $227.66 |
| Rest Of California | Office Unavailable | Facility $227.66 |
| Rest Of Florida | Office Unavailable | Facility $257.68 |
| Rest Of Georgia | Office Unavailable | Facility $242.71 |
| Rest Of Illinois | Office Unavailable | Facility $258.32 |
| Rest Of Louisiana | Office Unavailable | Facility $233.13 |
| Rest Of Maine | Office Unavailable | Facility $221.20 |
| Rest Of Maryland | Office Unavailable | Facility $238.30 |
| Rest Of Massachusetts | Office Unavailable | Facility $236.12 |
| Rest Of Michigan | Office Unavailable | Facility $241.07 |
| Rest Of Missouri | Office Unavailable | Facility $232.83 |
| Rest Of New Jersey | Office Unavailable | Facility $253.45 |
| Rest Of New York | Office Unavailable | Facility $225.64 |
| Rest Of Oregon | Office Unavailable | Facility $227.52 |
| Rest Of Pennsylvania | Office Unavailable | Facility $233.96 |
| Rest Of Texas | Office Unavailable | Facility $233.55 |
| Rest Of Washington | Office Unavailable | Facility $234.21 |
| Rhode Island | Office Unavailable | Facility $239.56 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $240.42 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $233.41 |
| Salinas | Office Unavailable | Facility $232.45 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $234.04 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $249.79 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $248.44 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $256.54 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $251.02 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $229.41 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $233.14 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $232.26 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $235.10 |
| Seattle (King Cnty) | Office Unavailable | Facility $249.41 |
| South Carolina | Office Unavailable | Facility $230.43 |
| South Dakota** | Office Unavailable | Facility $213.09 |
| Southern Maine | Office Unavailable | Facility $224.45 |
| Stockton | Office Unavailable | Facility $227.66 |
| Suburban Chicago | Office Unavailable | Facility $272.38 |
| Tennessee | Office Unavailable | Facility $217.37 |
| Utah | Office Unavailable | Facility $232.99 |
| Vallejo | Office Unavailable | Facility $240.96 |
| Vermont | Office Unavailable | Facility $219.44 |
| Virgin Islands | Office Unavailable | Facility $239.34 |
| Virginia | Office Unavailable | Facility $227.11 |
| Visalia | Office Unavailable | Facility $227.66 |
| West Virginia | Office Unavailable | Facility $251.28 |
| Wisconsin | Office Unavailable | Facility $210.27 |
| Wyoming** | Office Unavailable | Facility $229.15 |
| Yuba City | Office Unavailable | Facility $227.66 |
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38747 billing questions
Can 38747 be reported by itself?
No. It is an add-on code and must be reported with a primary procedure.
What should the operative note document?
Identify the abdominal nodal basin removed, such as celiac, superior mesenteric, or para-aortic nodes, and describe the extent of the dissection.
How does 38747 differ from 38780?
38747 describes regional abdominal lymph node removal. 38780 is for an extensive transabdominal retroperitoneal dissection that includes pelvic, para-aortic, and iliac nodes.
Does 38747 include pelvic lymph nodes?
It identifies regional abdominal nodes, not a pelvic-only dissection. For pelvic lymphadenectomy, consider 38770 when its service description matches the operation.
How does the global period affect this add-on?
The add-on is reported with a primary procedure, and its payment falls within that procedure’s global period. Related postoperative care is governed by the primary procedure’s global period.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,76138740,,Remove armpit lymph nodes,A,,10.43,7.06,NA,7.06,,2.68,20.17,20.17,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76238745,,Remove armpit lymph nodes,A,,13.52,8.22,NA,8.22,,3.41,25.15,25.15,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76338746,,Remove thoracic lymph nodes,A,,4.02,0.81,NA,0.81,,1.02,5.85,5.85,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76438747,,Remove abdominal lymph nodes,A,,4.76,1.22,NA,1.22,,1.19,7.17,7.17,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76538760,,Remove groin lymph nodes,A,,13.28,7.16,NA,7.16,,2.93,23.37,23.37,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76638765,,Remove groin lymph nodes,A,,21.36,10.50,NA,10.50,,4.83,36.69,36.69,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76738770,,Remove pelvis lymph nodes,A,,13.71,6.11,NA,6.11,,2.31,22.13,22.13,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00